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CHAPTER VI.

REVIVAL OF INOCULATION.

The practice of inoculation, thus discredited, revived, and not only revived, but prevailed. The revival was gradual, and may be said to have acquired definition about 1748, under the powerful approval of Dr. Mead. In the score of years from 1728 to 1748, it is not to be imagined that the practice was abandoned: there were always a few repeating the attempt to have smallpox without the penalties of smallpox, but success was not conspicuous or encouraging. Inoculation was introduced to a generation specially disposed to receive it; and it was only allowed to slip for a time under the compulsion of manifest disaster. Perhaps there never was a people with such a taste for dodges in favour of health as the English of last century: the common intelligence was invested in quackery. Even Wesley found time to dabble in medicine, and to compile a volume of prescriptions for his followers, entitled Primitive Physic—a piquant mixture of sense with absurdity and credulity. Our forefathers had no clear conception of the connection of physical well-being with physical well-doing, and many of the essential conditions of health were unknown to them. Their physical afflictions were regarded as mysterious dispensations to be endured with resignation or frustrated with medicines. The same attitude of mind is far from uncommon at the present day, and many will recollect how, ere sanitary science attained repute, it was considered profane to assert that typhus was subject to control, and that cholera might be suppressed; whilst a drug to subdue either would be heard of with gratitude. Superstition has rarely had any objection to the apothecary.

An incident passed over in histories, although far more inwardly characteristic of the mind of the 18th century than a multitude of the superficialities wherewith their pages are cumbered, is that of Joanna Stephens and her remedies for the stone. Her cures were so remarkable and (on evidence) so indisputable, that a general demand arose for the revelation of her secret for the public benefit. This revelation Mrs. Stephens agreed to make on receipt of £5000 as compensation; and a subscription was started, to which Fellows of the Royal Society, physicians, noblemen, bishops, ladies, and kindly folk of all orders set their names. Such, however, was the unanimity and anxiety to possess the Stephens secret, that it was pronounced a national concern, and Parliament was invoked to supply the requisite funds; whereon an Act was passed “for providing a reward to Joanna Stephens upon a proper discovery to be made by her of the medicines prepared by her for the cure of the stone.” The discovery was duly disclosed to appointed trustees, one of whom was Archbishop of Canterbury, and the £5000 was paid over in 1739; and here we have the heads of the precious revelation—

The public were apparently satisfied with the purchase, but with the usual levity of credulity forgot Mrs. Stephens and her marvellous cures in the pursuit of fresh nostrums. Fashions in medicine are on a par with fashions in dress, and have only occasional reference to the permanence and veracity of nature.

The revival of inoculation in England was stimulated by reports from abroad. For instance, in the Gentleman’s Magazine it was stated that in 1737 there were inoculated in Philadelphia—

and that out of the 128 only one Negro died. Again, in the same magazine for 1738 we read—

Such reports, whilst secure from examination, were none the less effective over the public imagination. There was a report published by Dr. Mead in 1747, which derived great credit from his endorsement, and which continues to be cited to the present day as proof for inoculation, but which is a model of convenient and circumstantial vagueness worthy of Defoe. Thus Mead’s story runs—

Mead held positions which later and more exact inquiry rendered untenable. He would not allow that the pus of smallpox could communicate any disease but smallpox, if taken from a proper subject—a condition that required supernatural assistance to fulfil. He maintained that inoculation generated true smallpox, and that as no one could have smallpox twice, therefore no one could have smallpox after inoculation, and that reports to the contrary were not credible. It now goes without saying that in this contention Mead was at fault, but at the time his confidence was not inexcusable; and whilst defending and recommending inoculation, he made admissions which fully justified those who resisted and condemned his counsels. Let us not forget that the following passage was published in 1747, and was the fruit of six-and-twenty years of experience in the best London practice. Thus Mead wrote—

How just are the judgments of Divine Order! These boils, swellings, and tumours, were the sequences of the violated harmony of the body—of the faithless anticipation, the meddling and muddling with its processes.

An extensive series of inoculations took place in 1742-45 in the south of England. Smallpox was prevalent in Winchester and adjacent towns, and Dr. Langrish operated freely on whoever resorted to him. In Portsmouth, Chichester, Guildford, Petersfield, and Winchester, it was said that at least 2,000 were poxed, and that only two pregnant women perished, who, as usual, “were inoculated contrary to the advice of their physician.” The ill results, wrote Bishop Maddox, “were only such as might reasonably be supposed to have been worse had those operated on had smallpox in the natural way”—such being the euphemism wherewith boils, tumours, and other sequelæ were accounted for.

The reviving favour for inoculation was indicated in this paragraph from the newspapers of 13th April, in 1744—

An important movement was made in 1746 with the opening of a Smallpox Hospital in Cold Bath Fields at which “the benefit of inoculation” was offered to the poor. At first those who applied were taken into the house, and nursed through their self-inflicted illness, but the proximity of the veritable smallpox, the regimen, and the seclusion were sufficient to deter applicants: those, however, who have a hobby to ride grow reckless in presence of obstacles, and by-and-by inoculation was offered to all comers, who were dismissed to recover and diffuse infection in their own homes.

With the revival of inoculation there was a revival of the controversy as to its lawfulness theologically. Dr. Isaac Maddox, Bishop of Worcester, preached a sermon on behalf of the Smallpox Hospital in St. Andrew’s, Holborn, on 5th March, 1752,[54] which excited considerable attention. He showed the necessity for such an hospital for the poor and forsaken of the great city—a necessity incontestable. He mentioned (and the remark supplies a curious note on the hygiene of the time) that ventilators were to be introduced, and it was expected that the access of fresh air might benefit the patients. The return of the Hospital for 1752 showed 344 admissions, with 262 recoveries, and 82 deaths—a proportion that does not contrast disadvantageously with 19th century hospitals, fortified with sanitary appliances. During the same year 112 inoculations were effected at the Hospital. The Bishop had been assured by three eminent surgeons that they had inoculated 1500 persons with only 3 fatalities, one of them (Sergeant Ranby) having accomplished one thousand without a mishap. The practice was without doubt lawful, for it averted a dangerous disease, and some risk was inseparable from all methods of cure. The practice had already done much to lessen smallpox, and, as it became commoner, it would do more. The result of the sermon was a subscription of £809 for the charity at the subsequent dinner in the Drapers’ Hall.

The Bishop was singularly at fault in his ascription of diminished mortality to inoculation, for, in 1752, smallpox was more than unusually rife in the Metropolis, and its prevalence was not unreasonably attributed to infection from the inoculated. In 1751 the deaths from smallpox in London were 998; they rose to 3538 in 1752; declined to 774 in 1753; and rose to 2359 in 1754.

Dr. Doddridge lent his powerful influence in favour of inoculation; and, considering the unqualified assertions of medical men as to its benefits and harmlessness, it cannot be said he was blameworthy. The audacious assurance with which many of them bore down opposition overcame the simple-minded, who argued as if the world were constituted after the pattern of their own innocent hearts. That smallpox frequently followed inoculation is now known beyond dispute, and yet Dr. Kirkpatrick wrote—

How could women and divines resist such evidence?

A voluble antagonist of inoculation was the Rev. Theodore Delafaye of Canterbury. He preached a sermon in that city on the 3rd of June, 1753, from the text, “Let us do evil that good may come” (Rom. iii. 8), and published it under the title of Inoculation an Indefensible Practice. He was in turn attacked by the inoculators, and in 1754 issued A Vindication of 200 pages, in which he returned more than he received with vigour rather than discretion. His conclusion was—

We sometimes read that inoculation was denounced as Atheism, and we are expected to reprobate or to smile at the bigotry; and, whilst we may not approve of the stigma, we may at the same time recognise the honest sense in which it might be affixed. Some who spoke of inoculation as Atheistic felt more vividly than they could otherwise describe, that it was an infraction of the deeper sanctity of Nature, where man’s hand cannot enter and prosper, and that those who made the attempt could have no proper sense of Him in whom they lived, and moved, and had their being. Moreover, if we are to admit that they who thus expressed themselves are blameable for excessive vehemence, what are we to say of the more numerous party who did not hesitate to pronounce inoculation a discovery effected in the human mind by God himself? If it was reasonable to speak of the practice as Theistic, why should it be fanatical to assert the contrary, and maintain that it involved a negation of Divine Providence? Dr. Kirkpatrick, with the sycophancy which was the custom of his age, praised George II. for “the benevolent, and even celestial disposition,” which induced him to patronise “the wonderful and probably Heaven-descended practice of inoculation;” and extolled “its equal simplicity and success” as demonstrating “to a reflective mind the goodness of Providence in making what may be so often necessary, so easily accomplished.”[56] It would not be difficult to cite scores of confessions of gratitude to God for inoculation, but to what purpose?

What we think good we necessarily ascribe to God; and we do well; but much that we think good is otherwise, or is only partially good; and what then? Why, we are undeceived and corrected by experience. We put our notion of what is good to the test of practice, and God answers us in the event—justifies, amends, or confounds us. Thus with inoculation. It was fair that those who thought it good should refer it to God, and thank him for it; and it was equally fair that those who thought it bad should say it was none of his—that it was at variance with his order, and a discredit to the intelligence of those who imputed it to Him. How was the issue to be determined? Only by God himself. And how would He speak? In the results of experience wherein his will would become manifest beyond equivocation.

In 1754 inoculation obtained full recognition from the London College of Physicians. It was declared “that experience had refuted the arguments urged against the practice; that it was now more extensively employed in England than ever; and that it was highly beneficial to mankind.” The fence of hesitation was thrown down, and to be inoculated became the distinction of all who wished to be numbered with the enlightened and prudent. That the Circassians were famous for their beauty, and that they practised inoculation, was a staple argument, and an irresistible, with a multitude of Englishwomen. Opposition was chiefly confined to the lower orders, who objected to have the inoculated at large among them, and in some places threatened to demolish the houses where inoculation was performed.[57] Occasionally a medical practitioner acquired reputation as an inoculator, and was resorted to by patients from a distance, and his operations were not regarded with much favour by his neighbours. Thus the physicians and surgeons of Newbury, Berks, were compelled by their townsmen to promise to inoculate no one who had not resided in Newbury at least two years.

The new practice created much business, and its distribution excited some jealousy. Physicians complained that surgeons inoculated without their assistance, and surgeons that apothecaries did so likewise. Dr. Kirkpatrick laid down the rule that every rightly conducted inoculation involved the employment of physician, surgeon, and apothecary—the physician to prepare and prescribe for the patient, the surgeon to cut, infuse, and dress, and the apothecary to make up the medicines. Some, however, dispensed with all three, and effected their own inoculations. A boy poxed fourteen of his school-fellows in sport, and amateur inoculators, male and female, multiplied. As an example of amateur procedure, Dr. Kirkpatrick relates that a gentleman of Kent sent his servant, Silvanus, a young man, to Mrs. Chapman, at Heathfield, to be inoculated. He had to ride thirteen miles, and arrived hot and fatigued at the house of the inoculatrix. As he had taken his preparatory physic at his master’s, Mrs. Chapman desired him to get ready at once for the operation, which he begged her to defer as he was in such a heat. She replied that he must be inoculated that very day, Tuesday, or remain until the following week, for Tuesday was her lucky day. The poor fellow allowed himself to be persuaded, and was then and there inoculated: severe smallpox ensued, and he died.[58]

Thus was inoculation revived and established, and smallpox with it—established and diffused.